INTRODUCTION: Epidemiological studies have emphasized the role of Streptococcus gallolyticus subspecies gallolyticus (Sgg) infection in the development of colorectal cancer (CRC), yet it remains underappreciated. While statistical and machine learning (ML) models can enhance CRC prediction, direct comparisons between them are rare. This study aims to assess the diagnostic accuracy of stool polymerase chain reaction (PCR) for Sgg and immunochemical fecal occult blood test (iFOBT) for CRC detection and to compare multivariable statistical and ML models in predicting CRC. MATERIALS AND METHODS: A hospital-based case-control study with a reversed flow design was conducted, involving 33 CRC cases and 80 controls. The analysis incorporated Asia Pacific Colorectal Screening (APCS) risk factors into three predictive models: logistic regression (LR), decision tree (DT), and ensemble Bayesian boosted decision tree (BDT). RESULTS: Combined testing achieved a net sensitivity of 54%, outperforming individual tests (iFOBT=12.1%, Stool PCR=48.5%). Among the models, the ensemble BDT approach demonstrated the highest classification accuracy for CRC (BDT= 78.1%; DT=72.4%; LR=69.9%). The DT model identified iFOBT as the sole predictor, while the BDT ensemble model prioritized positive stool PCR for Sgg as the primary predictor, followed by normal to overweight body mass index and individuals aged over 53 years. CONCLUSION: The ensemble ML model incorporating Sgg infection demonstrated superior predictive performance. Screening for Sgg in stool samples has the potential as an early CRC detection strategy, particularly for individuals with a normal to overweight BMI and those above 53 years old.

This case report describes a 45-year-old female who presented with acute hemiparesis and was initially diagnosed with acute ischemic stroke. Subsequent evaluation of her non-contrast computed tomography (NCCT) brain revealed a lesion in her spinal cord, which was further identified as intramedullary mass on cervical spine magnetic resonance imaging (MRI). This case underscores the importance of differential diagnosis in patients presented with acute hemiparesis, comprehensive assessment of NCCT scan, and the crucial role of MRI in diagnosing spinal cord lesions. Surgical intervention, involving laminectomy and excision of the lesion, was essential and resulted in significant postoperative improvement, highlighting the pivotal role of surgery in managing such conditions.

INTRODUCTION: Trimethyltin chloride is a compound utilized for inducing neurotoxicity.This study is to examine effects of Sauropus androgynus (SA) on cognitive function, Bax expression, neuronal number in the hippocampus and prefrontal cortex of rats induced TMT. MATERIALS AND METHODS: This is experimental study. Its subjects were 25 males of Rattus norvegicus. The subjects were divided into five groups: group K1 (no treatment), group K2 (TMT-induced), and groups of K3, K4, and K5 (TMT-induced with ethanol extract of SA at doses of 75, 150, and 300 mg/kg body weight respectively). The TMT at a dose of 6 mg/kg body weight. Cognitive function was measured by using the Y-maze spontaneous alternation test. Brain tissue was collected for histological preparations by using toluidine blue staining and immunohistochemistry with Bax antibody. Then microscopic observations were performed to count the number of neurons and Bax expression. RESULTS: The percentage of alternation in the SA extract groups (K3, K4, K5) was higher than that in the TMT group (K2). The number of neurons in the CA1 area of the hippocampus, dentate gyrus, and prefrontal cortex in the three groups (K3, K4, and K5) was higher than that in group K2. The expression of Bax in groups of K4 and K5 was lower than that in group K2. CONCLUSION: The SA extract could improve the memory function, inhibit the Bax expression, and increase the number of neurons in the CA1 area of the hippocampus, dentate gyrus, and prefrontal cortex in the rats induced with neurotoxicity using TMT.

Acute bilateral middle cerebral artery (MCA) infarctions are an extremely rare event. However, it can cause disruption of bilateral corticothalamic networks leading to coma. Detection of this condition is challenging as the early ischemic signs found on the non-contrast CT (NCCT) is depending on comparison between infarcted region and its normal counterpart. We report a case of 60-year-old man presented with acute comatose state and pulmonary oedema secondary to hypertensive emergency. His NCCT brain showed acute infarction of bilateral MCA territories. His acute pulmonary oedema subsequently resolved with the treatment. However, he succumbed to his illness and its complications on day 7 of admission. In this case report, we explore the strategy to improve detection of bilateral infarction on NCCT and navigating the differential diagnosis of comatose state and acute pulmonary oedema brought about by the hypertensive emergency.

Disorders/Differences of Sex Development (DSD) are congenital conditions characterized by atypical chromosomal, gonadal, or anatomical sex, affecting approximately 0.1–2% of the global population. A subset of individuals with DSD also experiences gender dysphoria (GD), a psychological distress arising from incongruence between assigned sex at birth and experienced gender. Misdiagnosis between GD and DSD remains a major concern, particularly in Muslim-majority contexts such as Malaysia, where socio-cultural, religious, and medical perspectives intersect. Many individuals with unrecognized DSD are mistakenly categorized as transgender, resulting in stigmatization, marginalization, and limited access to healthcare, education, and religious participation. Islamic jurisprudence introduces the concept of khuntha to describe sex ambiguity, which overlaps with some DSD cases but requires nuanced differentiation from mutasyabbih (gender imitation) and transgenderism. While classical scholars distinguished between khuntha wadhih (discernible) and khuntha mushkil (intractable), contemporary management demands multidisciplinary collaboration. Integrating medical expertise with Shariah rulings is essential to determine appropriate pathways, including gender assignment, surgical interventions, and psychosocial support. The absence of structured guidelines in Malaysia exacerbates clinical, ethical, and religious dilemmas in managing these complex cases. This paper argues for the urgent development of a national guideline that combines evidence-based medical protocols with Islamic jurisprudence, ensuring culturally competent and patient-centered care. Such a framework would harmonize the roles of endocrinologists, psychiatrists, psychologists, religious scholars, and community stakeholders, providing comprehensive management that upholds both health outcomes and spiritual well-being. Establishing this synergy positions Malaysia to pioneer an integrated model for DSD and GD management in Muslim societies.

Numerous studies in Malaysia have investigated the potential link between female reproductive factors and osteoporosis in postmenopausal women; however, a comprehensive synthesis of these findings is lacking. This systematic review seeks to elucidate the association between female reproductive factors and bone health indices in postmenopausal Malaysian women. A comprehensive search of PubMed, Scopus, and the Cochrane Library databases was conducted up to October 2024. Inclusion criteria comprised case-control and cross-sectional studies that reported comparisons, correlations, or regression analyses involving years-since-menopause, parity, or lactation with osteoporosis. Qualitative analysis was conducted on eight cross-sectional studies and one case-control study. Five out of the nine studies indicated a relationship between years-since-menopause and osteoporosis. Additionally, two out of four studies found a relationship between parity and osteoporosis, while two out of three studies demonstrated a relationship between lactation and osteoporosis. Quantitatively, a meta-analysis was performed for five studies, with a pooled sample size of 1134 postmenopausal women. A significant negative correlation emerged between years-since-menopause and osteoporosis indices (Fisher’s correlation coefficient: -2.51 [95% CI-0.305-0.195], p<0.001, fixed-effect model, I2 97%). Unfortunately, the available data on parity and lactation history were insufficient for meta-analysis of correlation. Limitations in the regression data did not allow for meta-analysis. The findings underscore the potential importance of years-since-menopause as a reproductive factor associated with osteoporosis in postmenopausal Malaysian women. Additional research is imperative to substantiate this association and contribute to the development of a robust risk assessment tool.

INTRODUCTION: The Malaysian Public Service Department reported many staff were at risk of mental health crisis or illness and an independent study revealed concerning rate of suicidal ideation. This study intends to: (a) describe the level of mental health literacy (MHL), mental health self-efficacy (MHSE), and mental well-being (MWB) among university administrative staffs, and (b) explore the dynamic influence between mental health literacy, mental health self-efficacy, and mental well-being. MATERIALS AND METHODS: A cross-sectional study using validated questionnaires was done on 91 administrative staff in one public university in Malaysia. The questionnaire consists of 37 items measuring MHL (subdimensions: knowledge, erroneous belief, first aid, and self-help), MHSE (subdimensions: optimism, factor coping, and advocacy), and MWB. Data was analysed using descriptive statistics, Pearson’s correlation, and multiple linear regression. RESULTS: The mean scores for subdimensions of MHSE ranged from 14.2 to 28.6 (SD=2.73 to 4.45), subdimension of MHL from 6.1 to 25.5 (SD=2.17 to 3.35), and MWB was 18.5 (SD=3.36). Correlation analyses revealed all subdimensions of MHSE and MHL, as well as MWB showed significant weak to strong correlation (r=0.22 to 0.69). Only optimism subdimension of MHSE retained significance in predicting MWB (B=0.43) and among MHL subdimensions, only first aid retained significant prediction to optimism. CONCLUSION: The findings provide valuable insights to the dynamic role between subdimensions of MHL and MHSE, as well as their contribution towards MWB. Healthcare professionals should consider this dynamic into designing mental health promotion activity.

Penetrating brain injury (PBI) is a rare but severe form of traumatic brain injury, especially when caused by non-missile, low-velocity objects. We report a case involving a 12-year-old boy who sustained a penetrating frontal brain injury after falling with a scissor in hand during a school activity. The scissor penetrated the right orbital roof and entered the anterior cranial fossa, injuring the right frontal lobe and causing an intraparenchymal hematoma. Computed tomography (CT) confirmed the trajectory and extent of injury. The patient underwent emergency craniotomy and foreign body removal. Postoperatively, he recovered without neurological deficits, cerebrospinal fluid (CSF) leakage, or recurrent seizures. This case highlights the importance of timely imaging, careful surgical planning, and adherence to management principles to optimize outcomes in pediatric PBI.

INTRODUCTION: Environmental tobacco smoke (ETS) poses significant health risks globally, particularly for children. This study aimed to determine levels of self-efficacy, knowledge, attitude, and avoidance practices regarding ETS exposure among mothers with children under six and identify factors associated with avoidance practices. MATERIALS AND METHODS: A cross-sectional study was conducted using the validated Malay SE-KAP-ETS questionnaire among 321 mothers. Higher scores indicated better self-efficacy, knowledge, attitude, and avoidance practices. Multiple linear regression (MLR) analysis was performed to determine associations. RESULTS: Participants had a mean age of 33.4(±5.57), and 67.9% had tertiary education. Mean scores were: self-efficacy 36.41(±9.7), knowledge 38.26(±3.76), attitude 48.58(±3.75), and avoidance practices 28.33(±3.27). MLR revealed that no smokers at home [B=0.700, 95%CI: 0.304, 1.462; p=0.003], higher self-efficacy [B=0.058, 95% CI: 0.028, 0.088; p<0.001], and positive attitudes [B=0.414, 95%CI: 0.336, 0.491; p<0.001] were positively associated with avoidance practices. Conversely, primary and secondary education [B=-0.750, 95% CI: -1.449, -0.051; p<0.035] and self-employment [B=-1.517, 95%CI: -2.584, -0.450; p=0.005] were negative predictors. CONCLUSION: Findings indicate that although ETS knowledge is high among mothers of young children in Selangor, it does not predict avoidance practices. Instead; self-efficacy, attitude, and smoke-free homes are critical determinants, underscoring the need for empowerment-focused interventions, particularly for mothers with primary and secondary education.